Specialty Clinic of Austin PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

N5934 Issued in TX

Legal business name

SPECIALTY CLINIC OF AUSTIN PA

Practice address

4515 Seton Center Pkwy
175
Austin, TX 78759-5290

Phone

(512) 302-1954

NPI assigned

Jan 22, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Divyansu Patel, MD

Title

Vice President

Phone

(440) 376-7948

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1093053373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SETON CENTER PKWY",
            "address_2": "175",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 SETON CENTER PKWY",
            "address_2": "175",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595290",
            "telephone_number": "512-302-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY CLINIC OF AUSTIN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-22",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DIVYANSU",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "440-376-7948",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "N5934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.